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{
    "pk": 17770,
    "title": "Seizure as Initial Manifestation of Aortic Dissection Type A",
    "subtitle": null,
    "abstract": "Background: Seizure as the initial manifestation of aortic dissection is rare.\n\n\nCase report: An 88-year-old female experienced a first generalized tonic clonic seizure, which was terminated with midazolam. Acute cerebral magnetic resonance imaging and angiography were non-informative. After awaking she complained about cramping pain in the right upper extremity, which was accompanied by involuntary flexion movements of the right upper extremity. Blood pressure was initially normal. Blood gases revealed metabolic acidosis and blood chemical investigations a markedly increased D-dimer. Consecutively blood pressure declined and transthoracic echocardiography showed pericardial effusion. A computed tomography scan of the thorax revealed an aortic dissection type A. The patient died 16 hours after admission after cardiothoracic surgeons had refused surgical treatment.\n\n\nConclusion: This case shows that a generalized tonic-clonic seizure may be the initial manifestation of an aortic dissection type A in the absence of thoracic chest pain and that brachyalgia may not develop earlier than with progression of the dissection. [West J Emerg Med. 2010; 11(5):510-511.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "epilepsy"
        },
        {
            "word": "Seizure"
        },
        {
            "word": "carotid artery"
        },
        {
            "word": "Aortic Dissection"
        },
        {
            "word": "cardiac surgery"
        },
        {
            "word": "cardiology"
        },
        {
            "word": "Neurology"
        }
    ],
    "section": "Article",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2969w3kb",
    "frozenauthors": [
        {
            "first_name": "Josef",
            "middle_name": "",
            "last_name": "Finsterer",
            "name_suffix": "",
            "institution": "Vienna, Austria, Europe",
            "department": "None"
        },
        {
            "first_name": "Marlies",
            "middle_name": "",
            "last_name": "Frank",
            "name_suffix": "",
            "institution": "Vienna, Austria, Europe",
            "department": "None"
        },
        {
            "first_name": "Hans",
            "middle_name": "",
            "last_name": "Keller",
            "name_suffix": "",
            "institution": "Vienna, Austria, Europe",
            "department": "None"
        },
        {
            "first_name": "Adam",
            "middle_name": "",
            "last_name": "Bastowanski",
            "name_suffix": "",
            "institution": "Vienna, Austria, Europe",
            "department": "None"
        }
    ],
    "date_submitted": "2010-04-23T11:00:00+04:00",
    "date_accepted": "2010-04-23T11:00:00+04:00",
    "date_published": "2010-11-10T11:00:00+03:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17770/galley/9074/download/"
        }
    ]
}